1. The Importance of End of Life Planning
Balmore Park Surgery PPG
Wednesday 22nd March 2017

2. “Death is a very dull, dreary affair, and my advice to you is to have nothing whatever to do with it.”
W. Somerset Maugham

3. 1917 1/5 all deaths due to infection
1/3 all deaths under 5 years of age
Life expectancy 50
Death was an expected and accepted occurrence
Most deaths then would be considered preventable now

4. 1950s Heart disease leading cause of death Largely untreatable
37% deaths occurred in hospital

5. 2013 Cancer, as a broad group, leading cause of death
Men 1. Heart Disease
2. Lung Cancer
3. Dementia
Women 1. Dementia
2. Heart Disease
3. Stroke

6. Dementia
Dementia is only the leading cause of death in women in the >80 age group
63% women age of death >80

7. Place of Death (%) Place 1984-92 2001-2010 Hospital 64.7 57.3 Home
24.1
19.0
Hospice
N/A
5.1
Care Home
17.2
Other
11.1
1.4

8. Society Changes Less nuclear families Children further away
More women working
More secular
Therefore, people are often more isolated, with less family
or community support, during the end of life period

9. Patient Autonomy
Patients are increasingly encouraged, and expected, to be involved in their management

10. 21st Century End of Life Causes of death have changed
Death often seen as medical failure to be avoided
End of life period longer
Cognitive impairment common
Patients expected to be involved more